The Obama administration and federal courts are wrangling over changes to the regulations governing access to emergency contraceptives. The administration supports new rules that would allow girls as young as 15 to purchase the drug without a prescription, while a New York judge has ordered it be made available to anyone, regardless of age. With those changes pending, we asked Todd Brown, vice chair of the Department of Pharmacy Practice in the Bouvé College of Health Sciences, to explore the issue.
How do emergency contraceptives work?
Most of these products have to be taken within three days, though newer ones can be taken within five days. All work essentially the same way, mainly by impairing or preventing ovulation. If a woman is already pregnant, these products will not work. They’re not designed to be a normal contraceptive, so they shouldn’t be used regularly. They’re for when either there is a contraceptive failure or if someone had unprotected sex and does not want to be pregnant.
The original labeling, because of a push by opponents of the drug, says that all emergency products work not only by inhibiting ovulation but also by preventing an already fertilized egg from attaching to the uterus. But the claim that these drugs work by preventing the implantation of an egg into the uterus has never been proven, and, in fact, there is data that shows it does not work that way. But people who oppose contraception have really tried, largely through politics, to keep that labeling in place.
Why do many medical professionals believe in eliminating barriers to obtaining emergency contraceptives?
Time is of the essence when you’re taking a drug like this. If a woman has to get a prescription from her doctor, she simply may not have enough time to obtain the drug. They feel it’s also important to get the drug out from behind the pharmacy counter. A woman may be asked questions and be intimidated from purchasing emergency contraceptives, or she may go to a drug store with a pharmacy that may not be open at the time she’s there to get the contraceptive. Lastly, the manufacturers have proven that women as young as 15 can understand the labeling and warnings contained on the package.
What specific concerns does reducing or eliminating the minimum age for obtaining emergency contraceptives pose for pharmacies?
From a health professional’s standpoint, one big concern is that pharmacies are going to have to verify the age of the customer. And 15-year-olds don’t have IDs or a driver’s license, so it’s unclear how pharmacies and cashiers are going to be able to determine their age.
But for pharmacists, providing contraception to girls that age isn’t a major concern. The American Academy of Pediatricians has general guidelines that say doctors should talk to their young female patients about abstinence and offer oral contraceptives if they are sexually active. Pharmacies already provide this medication without issue, and the law does not require parental consent.